Mapleton Student Safety Reporting Form
This form is to report bullying, harassment, and other concerns. Do the best you can to fill out the information below. Once this digital form is submitted, it will be processed by an administrator or other school official.
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School
Name of the person(s) who experienced the incident:
Name of the person filling out this form (Note: you may report anonymously if you prefer, but having this information may help us investigate the concern):
Contact Information (phone):
Name(s) of the person(s) of concern:
Describe what is happening or what has happened:
Where did it happen? (Example: classroom, on-line, off campus):
When did it happen? (date and time of day)
Who were the people involved?
Who saw it?
Has this type of behavior happened before? If yes, please tell us more about that.
Do you have a teacher or other advisor, mentor, or parent supporting you? Who?
Besides stopping the unsafe behavior, what would you like to see happen?
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